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Rwandan medical schools receive international boost

Recent efforts by Brown medical professionals and health care providers from other institutions to strengthen medical provider training in Rwanda were outlined in a report published Nov. 21 in the New England Journal of Medicine.

Sub-Saharan Africa bears 24 percent of global disease but is served by a mere 4 percent of global health care providers, according to the report. With a health care provider density of only .84 health care providers per 1,000 citizens, Rwanda falls well below the World Health Organization’s recommended density of 2.3 providers per 1,000 citizens.

In 2010, the country’s per capita health care spending amounted to $56, and from 2004 to 2010 only 100 physicians graduated from the nation’s sole medical school, according to the report. These factors contribute to Rwanda’s dearth of health care providers and situated the nation as the focal point for the national Human Resources for Health Program currently underway.

Under the program’s umbrella, 100 American health care providers from 25 American medical institutions, including Brown, join the ranks of medical faculty at the medical school in Kigali, Rwanda each year with aims to improve medical education in the country. Launched in 2012, the $150 million initiative is planned to last seven years, after which Rwanda will run the residency and training programs on its own budget and with its own manpower, according to the report.

The partnership between Rwandan- and American-grown medical professionals benefits both groups, the report argues. Rwandan students gain access to specialized clinical teaching, and Americans return better equipped to strengthen global health programs at home after their time in Rwanda. Brown medical faculty who have participated in the partnership include Alpert Medical School professors Michael Koster, Adam Levine and Brian Montague, according to a University press release.

The program aims to improve both the quality and the quantity of health care professionals in Rwanda, according to the report.


Tracking web-initiated sex abuse

The number of Internet-initiated sexual abuse cases with female victims increased between 1996 and 2007, while the number of cases with male victims remained constant, according to a recent study conducted by University researchers.

Scouring newspaper reports of adolescent sexual assault cases, the researchers tracked the incidence of Internet-initiated sexual assault among American teenagers from 1996 to 2007.

Though reported Internet-initiated assault rates are much lower than rates of other types of sexual assault, newspapers reported 812 Internet-initiated assault cases over the examined timeframe, according to the study.

Among these cases, 79 percent of victims were female, with a median age of 14.

The results of the study may provide insight into how these assaults occur, help in developing preventative strategies and help guide sexual assault policymaking, the researchers wrote.


The machine in the room

Researchers at the School of Public Health are exploring the possibility of developing a machine to transcribe doctor-patient encounters automatically. Manual transcriptions of clinical encounters are “expensive,” creating a barrier to widespread record-keeping of interactions in the clinic, according to the study, which was published Nov. 27 in PubMed.

To study the accuracy of an automatic transcription machine, the researchers analyzed 360 different outpatient visits. They compared the transcriptions generated by the automatic machines with transcriptions generated manually by human annotators. They found that automated transcriptions were capable of recording patient-provider interactions with an accuracy of 64 percent, the researchers wrote.

The automatic transcribers remain “far from perfect” but offer promise for greater implementation of medical transcriptions, which can “provide important insights into clinical communication” and ultimately effect better health outcomes, according to the study.


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